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Antibiotic resistance among the AIDS...

DeNegre, Ashley A.

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Antibiotic resistance among the AIDS-immunocompromised: A model of its influence on microbial evolution.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Antibiotic resistance among the AIDS-immunocompromised: A model of its influence on microbial evolution./
作者:	DeNegre, Ashley A.
面頁冊數:	130 p.
附註:	Source: Dissertation Abstracts International, Volume: 77-08(E), Section: B.
Contained By:	Dissertation Abstracts International77-08B(E).
標題:	Ecology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10095936
ISBN:	9781339600925

Antibiotic resistance among the AIDS-immunocompromised: A model of its influence on microbial evolution.
DeNegre, Ashley A.

Antibiotic resistance among the AIDS-immunocompromised: A model of its influence on microbial evolution. - 130 p.

Source: Dissertation Abstracts International, Volume: 77-08(E), Section: B.

Thesis (Ph.D.)--Rutgers The State University of New Jersey - New Brunswick, 2016.

First recognized in 1981, the AIDS pandemic has had a tremendous impact on global public health. Despite the development of highly active anti-retroviral therapy, which significantly slows the progression of HIV, HIV/AIDS continues to pose a significant health concern; its effects on the immune system leave individuals with active AIDS at increased risk for colonization by opportunistic pathogens. To address this, AIDS patients have traditionally relied upon curative and prophylactic antibiotics to treat and prevent infection, respectively. However, the use of antibiotics exerts a selective pressure against drug-sensitive microbial strains, thus bolstering the evolutionary fitness of drug-resistant strains by allowing them to persist without competition. When this occurs, resistant strain dominance can threaten the efficacy of both targeted and prophylactic antimicrobials, thereby creating health risk for both immunocompetent and immunocompromised hosts.

ISBN: 9781339600925Subjects--Topical Terms:

516476
Ecology.

Antibiotic resistance among the AIDS-immunocompromised: A model of its influence on microbial evolution.
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245 1 0 $a Antibiotic resistance among the AIDS-immunocompromised: A model of its influence on microbial evolution.
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500 $a Adviser: Nina H. Fefferman.
502 $a Thesis (Ph.D.)--Rutgers The State University of New Jersey - New Brunswick, 2016.
520 $a First recognized in 1981, the AIDS pandemic has had a tremendous impact on global public health. Despite the development of highly active anti-retroviral therapy, which significantly slows the progression of HIV, HIV/AIDS continues to pose a significant health concern; its effects on the immune system leave individuals with active AIDS at increased risk for colonization by opportunistic pathogens. To address this, AIDS patients have traditionally relied upon curative and prophylactic antibiotics to treat and prevent infection, respectively. However, the use of antibiotics exerts a selective pressure against drug-sensitive microbial strains, thus bolstering the evolutionary fitness of drug-resistant strains by allowing them to persist without competition. When this occurs, resistant strain dominance can threaten the efficacy of both targeted and prophylactic antimicrobials, thereby creating health risk for both immunocompetent and immunocompromised hosts.
520 $a Although mathematical modeling has been used to study the emergence of antibiotic resistance in a variety of settings, the question of how the microbial evolutionary landscape is changed by a highly immunocompromised host population has not been addressed. My research uses compartmental epidemiological modeling to examine the evolutionary effects of changes in the prevalence and fitness of drug-sensitive and drug-resistant pathogens due to antibiotic use in highly AIDS-affected regions. I apply an SEIR model to study the means by which collective host immunosuppression creates a novel environment for the emergence and maintenance of drug-resistant bacterial pathogens. Broadly, I address three questions.: First, I examine the immune status-based differences in relative contribution to the emergence of antibiotic resistance when curative antibiotic adherence is varied among the actively AIDS-immunocompromised. Second, holding HIV/AIDS prevalence constant, and varying percent antibiotic prophylaxis treatment among HIV/AIDS patients, I analyze the risks and benefits of prophylaxis use. (Although prophylactic use prevents opportunistic infection, it potentially selects for the emergence of antibiotic resistance at the same time.) Third, I vary the prevalence of prophylactic antibiotic and resistant strain fitness to analyze the condition-dependent differences in the evolutionary success of drug-resistant and drug-sensitive pathogen strains.
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